Effect of a pedometer-based walking intervention on body composition in patients with ESRD: a randomized controlled trial

Abstract

Background: A randomized trial of a pedometer-based intervention with weekly activity goals led to a modest increase in step count among dialysis patients. In a secondary analysis, we investigated the effect of this intervention on body composition.Methods: Sixty dialysis patients were randomized to standard care or a 6-month program consisting of 3 months of pedometers and weekly step count targets and 3 months of post-intervention follow-up. We obtained bioelectrical impedance spectroscopy (BIS) data on 54 of these patients (28 control, 26 intervention) and used linear mixedmodeling (adjusted for sex and dialysis modality) to estimate differences in change in total-body muscle mass (TBMM) adjusted for height 2 , fat mass (kg), and body mass index (BMI) (kg/m 2 ) between control and intervention groups.Results: The median age of participants was 57.5 years (53-66), and 76% were men. At baseline, there was no significant difference between groups in age, BMI, race, or body composition, but there were more men in the intervention group. After 3 months, patients in the intervention group increased their average daily steps by 2414 (95% CI 1047, 3782) more than controls (p < 0.001), but there were no significant differences in body composition. However, at 6 months, participants in the intervention had a significantly greater increase from baseline in TBMM of 0.7 kg/m 2 (95% CI 0.3, 1.13), decrease in fat mass (− 4.3 kg [95% CI -7.1, − 1.5]) and decrease in BMI (− 1.0 kg/m 2 [95% CI -1.8, − 0.2]) relative to controls. In post-hoc analysis, each increase of 1000 steps from 0 to 3 months was associated with a 0.3 kg decrease in fat mass (95% CI 0.05, 0.5) from 0 to 6 months, but there was no dose-response relationship with TBMM/ht 2 or BMI. Conclusion: A pedometer-based intervention resulted in greater decreases in fat mass with relative preservation of muscle mass, leading to a greater decrease in BMI over time compared with patients not in the intervention. These differences were driven as much by worsening in the control group as by improvement in the intervention group.Step counts had a doseresponse relationship with decrease in fat mass.Trial registration: ClinicalTrials.gov (NCT02623348). 02 December 2015.

The Effects of a 7000-Step Goal and Weekly Group Walking Program for Overweight and Obese Elderly People in Sarawak, Malaysia: A Quasi-experimental Study

“…This study reported a decrease in fat percentage of 3.52% (equivalent to 3.01 kg), a decrease in visceral fat percentage of 1.29% (equivalent to 0.95 kg), and a decrease in waist circumference of 2.91 cm. These findings are supported by other studies that showed a range of body fat loss from 1.9% to 3.9% after 12-week and 24-week pedometer-based interventions [ 21 , 23 , 32 ].…”

“…Two studies were conducted on middle-aged and older adults, using pedometer-based interventions over a period of 12 weeks. Those studies found that 12-week interventions produced significant decreases in body weight (ranging from 1.2 to 2.5 kg) and BMI (ranging from 0.6 to 1.0 kg/m 2 , p <0.001) [ 23 , 24 ].…”

Beneficios de la podometría en la prevención de factores de riesgo cardiovascular

“…Esto se debe a que proporcionan una retroalimentación inmediata al usuario, al visualizar el número de pasos dados en el día, permitiendo el cumplimiento de objetivos individuales para estimularlos a alcanzar un mayor número de pasos 19 . Eso demuestra que pueden generar beneficios en la composición corporal y otros parámetros que contribuyen a la salud cardiovascular 13 .…”

“…Al ser un instrumento práctico y accesible para la población en general, el podómetro cuantifica el número de pasos y es usado para realizar programas de intervención basados en caminata 12 , ya que resulta efectivo al brindar motivación e incrementar la actividad física en personas con alguna morbilidad crónica y así beneficiar su salud 13 .…”

Dietary protein interventions to improve nutritional status in end-stage renal disease patients undergoing hemodialysis

“…Although aerobic exercise has been shown to increase aerobic capacity in CHD patients [ 42 ], resistance-type exercise is considered to be the most potent form of physical activity to increase muscle mass and strength [ 43 ]. Nevertheless, a recent study by Sheshadri et al [ 44 ▪ ] reported that low-intensity exercise (i.e. walking) already resulted in improved muscle mass maintenance in CHD patients.…”